Effectiveness of Influenza Vaccine in Hemodialyzed Patients: A Retrospective Study

Infection is one of the leading causes of mortality in dialysis patients, second only to cardiovascular disease. This retrospective study assessed the efficacy and clinical outcomes of influenza vaccination among hemodialysis (HD) patients. In the 2014–2015 season, 104 of 164 (63.6%) HD patients were vaccinated for influenza by the outpatient community health system facilities. Significantly more patients, 159 of 170 (93.8%), were vaccinated in 2015–2016 by the hospital dialysis unit staff during an inpatient HD session (P <0.001). A trend toward fewer complications from influenza infection was observed in vaccinated patients. Among HD patients with diabetes (who comprised 56% of the study population), the incidence of influenza was 17% among nonvaccinated patients vs. 6.3% among those who were vaccinated (P =0.026). The inpatient vaccination policy resulted in a greater rate of vaccination. HD patients with diabetes benefit from influenza vaccination, with a significantly lower incidence of influenza infection.     

Low dose amitriptyline in chronic pain: the gain is modest

In the double-blind placebo-controlled study presented here, the effects were investigated of a low dose of amitriptyline (75 mg) in patients with chronic pain of various origins. The active drug was superior to placebo in reducing pain intensity. The reduction was small. In the second treatment week, the amitriptyline treated patients slept longer. No differences between active drug and placebo were found with respect to daily activities or use of analgesics. Based on our data and those of other studies, it is concluded that amitriptyline (and other antidepressants) in low doses does have a positive effect on the intensity and some other aspects of chronic pain, but that the effect is modest. It must be kept in mind that chronic pain is a very treatment-resistant condition. Therefore, even modest positive effects may be worthwhile.     

Umsatzsteuerpflicht bei ästhetischen Operationen

Abstrakt  1. ?sthetische Operationen unterliegen der Umsatzsteuerpflicht. 2. Ums?tze aus der T?tigkeit als Arzt sind nur dann umsatzsteuerfrei, wenn sie der Diagnose, Behandlung und Heilung von Krankheiten oder Gesundheitsst?rungen dienen.     

Lifestyle and dietary correlates of dispositional optimism in men: The Zutphen Elderly Study

OBJECTIVE: Dispositional optimism has been associated with a lower risk of cardiovascular mortality, but the underlying mechanisms are still largely unknown. We therefore studied whether dispositional optimism was associated with healthy lifestyle and dietary habits. METHODS: In 773 (87.1%) of 887 Dutch elderly community-living men with complete data in 1985, the associations of dispositional optimism with lifestyle and dietary factors were assessed at baseline and during follow-up every 5 years up to 15 years using multilevel regression models. MEASUREMENTS: Dispositional optimism was assessed using a four-item questionnaire, and the participants' food consumption was assessed by a cross-check dietary history method that estimates the usual food consumption pattern of the participants. Lifestyle factors were assessed by questionnaires, while weight and height were measured to calculate body mass index. RESULTS: A high level of dispositional optimism was associated with more physical activity (P<.001), nonsmoking (P=.02), and higher intakes of alcohol (P=.046), fruit (P=.01), vegetables (P=.01), and whole-grain bread (P=.01), independently from age, education, living arrangement, self-rated health, cardiovascular disease, diabetes mellitus, cancer, and body mass index, as well as total energy intake (for dietary factors). CONCLUSION: Dispositional optimism in elderly men is associated with healthy lifestyle and dietary habits. A low level of optimism may indirectly affect proneness to cardiovascular death via unhealthy behavioral choices.     

A within-subjects comparison of learning and memory performance before and after cardiac catheterization

OBJECTIVE: To investigate the influence of stress on the recall of neutral information in a clinical setting, a prospective study was performed on patients who were admitted to the hospital for cardiac catheterization. METHODS: During their hospital stay, 39 cardiac patients were tested for verbal recall and face recognition before cardiac catheterization (day 1) and 24 h after (day 2). Plasma cortisol levels were also determined. After catheterization, recognition of faces presented to each patient before catheterization was assessed. RESULTS: Patients' verbal recall scores on both day 1 and day 2 were within normal limits for the age group but were significantly higher on day 1. Face recognition on day 2 was excellent. Blood cortisol levels did not differ significantly on days 1 and 2, and no significant relationship was found between change in cortisol levels and change in verbal recall scores. CONCLUSIONS: In this small group of selected patients, the stress of hospital admission and cardiac catheterization may not have impaired the recall of neutral information. These preliminary results may indicate that whenever it is necessary to provide information to the patient it is advisable to do so before cardiac catheterization.